Fibrinolytic therapy for bilateral renal vein thrombosis

A patient with nephrotic syndrome due to membranous glomerulonephritis experienced painful bilateral renal vein thrombosis (RVT) complicated by pulmonary emboli. He was treated with systemic fibrinolysis with streptokinase for 72 hours. Rapid clinical improvement of his condition, a fall in his serum creatinine level, and a sharp rise in his platelet count were observed. Venography verified complete lysis of the thrombus within the vena cava and reperfusion of the right renal vein. The left renal vein remained chronically occluded. Thrombolytic therapy should be further investigated as initial therapy for patients with clinical evidence of RVT.